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I Think I Understand...
May 15, 2008

Hello Dr. Bob,

Yes, unfortunately, this is another oral question. You can begin groaning now. : )

I just want to clarify a few things.

If a guy is going down on me (I'm a guy who is rather well endowed. Lucky me.) it is not his saliva that can infect me, but rather possible trauma in his mouth. Trauma so significant as to create blood in his mouth, lots of blood that would have to make contact with the urethra and make its way down it. Is that correct? Is it because of these very difficult and improbably set of circumstances that insertive oral sex is considered such a low, low risk act?

I would think it hard to get anything down a urethra unless really forcing it in there, but I do realize some guys do love that tonsil-pounding oral.

Am I pretty spot on on all this?

Thank you!

Response from Dr. Frascino

Hi,

Well, yes, there is often a lot of groaning going on whenever there is a lot of oral going on. But that's normal, right? (Especially with well-endowed guys!)

You seem to be getting the gist of the information, but I'm not sure you are exactly "spot-on" just yet. True, saliva without the presence of visible blood is not felt to be a significant risk for HIV transmission, except perhaps in the case of HIV-positive mothers pre-chewing foods for their infants. Also true is that trauma that causes bleeding would increase the potential risk of HIV transmission. What you fail to mention is other factors that can contribute as well, such as bleeding gums (without excessive trauma), gum disease, sores in the mouth and concurrent infections that cause inflammation. Also you seem to be under the impression that the HIV-tainted fluid or blood would need to "make its way down" the urethra. Actually all it needs to do for potential HIV transmission is come in contact with a mucous membrane. HIV can be actively absorbed across mucous membranes. The urethra is lined with a mucous membrane right up to its opening. Consequently it's not necessary for infected fluids to "make their way down," but rather to just come in contact with mucous membranes.

Hope that helps both you with your tonsil-pounding activities and your boyfriends with their absent gag reflex.

Stay safe. Stay well, Big Guy.

Dr. Bob



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